COMBINED ANESTHESIA WITH ADVANCED OPERATIVE INTERVENTIONS IN ONCOLOGICAL PRACTICE

Abstract

Aim. To study the development and clinical approbation of an approach to the implementation of combined general anesthesia in patients with oncological diseases undergoing advanced surgical interventions. Material and methods. A total of 191 patients with cancer of the stomach, pancreatic head and colon that underwent extended surgical procedures were examined. The patients were divided into 2 groups: patients that received total intravenous anesthesia with propofol (n = 75); patients that received combined anesthesia with propofol + sevoflurane and propofol + isoflurane (n = 116). With combined anesthesia, the concentration of anesthetics was 0.3-0.5 vol.%, Propofol was injected with a syringe pump at a dose of 20-30 ml/h.Results: The average values of central hemodynamic parameters underwent greater changes during the intravenous anesthesia than during combined anesthesia. The combination of anesthetics provided less depression of the contractile ability of the heart. Combined anesthesia provided a greater degree ofprotection from operational stress, which was expressed in a lower content of cortisol in the blood during the intervention. The mean values and variability of the BIS-index were also optimal during combined anesthesia. Conclusion: The use of anesthesia with the combination of propofol + inhalation anesthetic provides an adequate level of analgesia with minimal risk of side effects and post-anesthetic complications in oncological practice.